DEARBORN – Health care providers in Michigan have come under scrutiny in light of recent cases convicting physicians for fraud, money laundering and misdiagnosing patients. 

Throughout history, medical doctors have been among the most trusted professionals. People usually place full confidence in the diagnoses of physicians, who spend on average of eight years in college before starting their professional careers.

However, more patients are beginning to recognize the fallibility of their physicians as medical information is readily available on the web.

Doctors with bad intentions

High profile court cases and criminal convictions exposing doctors who prioritize financial benefits instead of patients’ wellness have also jeopardized the presumed trust in medical professionals. 

In September of last year, cancer specialist Dr. Farid Fata of Rochester Hills was indicted for intentionally misdiagnosing more than 550 patients with cancer and administering unnecessary high doses of chemotherapy.

He also pled guilty to 13 counts of healthcare fraud, cashing in more than $17 million; two counts of money laundering and one kickback count.

Fraud and misdiagnoses are not only committed by wealthy healthcare professionals and executives, but also by local physicians with more moderate incomes.

This year in Michigan, some 1,200 healthcare professionals, including family doctors, specialists, chiropractors and pharmacists, have been disciplined by the state for violating the Public Health Code, according to state records.

These include 16 in Dearborn and six in Dearborn Heights, many of whom were disciplined for negligence, “lack of moral character” and substance abuse related charges.

Enforced by the Department of Licensing and Regulatory Affairs (LARA), the penalties encompass fines, probation, suspension, revoking or placing conditions on a doctor’s medical license.

This past January, Detroit physician Carl Dennis Fowler’s license to practice medicine was suspended based on his convictions of one count of health care fraud conspiracy, conspiracy to distribute controlled substances and conspiracy to send and receive kickbacks.

Fowler was sentenced to six years in prison and ordered to pay about $1.8 million, along with his co-defendants.

Many local physicians have been penalized over the span of decades, but continued to practice and diagnose patients. 

David, a Dearborn Heights doctor whose last name is withheld for privacy concerns, has been on probation, suspended and fined multiple times since 1998. He has been charged with several accounts related to alcohol abuse and allowing a non-qualified nurse to prescribe schedule 2 drugs. 

Cocaine is a schedule 2 drug.

Any health professional’s license and associated records are public and can be viewed on LARA’s website for free.

Establishing doctor-patient trust

As information on medical conditions and treatment becomes more easily attainable from the Internet, patients are increasingly becoming more involved in making decisions about their diagnoses.

Dr. Mohamad Khansa, a Dearborn-based internal medicine physician, said trust between a doctor and a patient is built on open communication, which increases recovery rates and decreases the possibility of misdiagnosis.

“The doctor should make the patient a part of the decision making process,” Khansa said. “Certain medication causes side-effects that the patient has to understand, and it will be up to the patient to decide whether they will take it or not.”

Khansa added that timely follow up after a patient is put on medication is key to determining if the diagnosis is correct and allows room for correction.

He also said doctors should know their limitations in the care they are able to provide. Many patients require specialized care, which also cuts down on the likelihood of misdiagnosis, he added.

Arab American patients

Most of Khansa’s patients are Arab Americans. He said many members of that community have a tendency to put up walls between themselves and their physicians, making it more difficult to determine the best diagnosis.

In some cases, Arab patients fear talking to their doctors about psychiatric diseases like depression and insomnia. They also hide histories of drug abuse and domestic violence in fear of information leaking to the community.

Peyman Kabolizadeh, a radiation oncologist at the Beaumont Cancer Institute in Royal Oak, said Middle Easterners respect doctors more than most other professionals.

Kabolizadeh said the best way to build doctor-patient trust is to “talk about their disease privately, talk about their options, their values and their priorities.”

Khansa said due diligence is required from anyone seeking treatment and suggests doctors and patients have a discussion of all aspects of their medical history and problems. He also urges patients not hide drug use or sexual activity.

He acknowledged that total confidence between a doctor and a patient takes time. He added that the first step in establishing that relationship is to explain the laws enforced by the Health Insurance Portability and Accountability Act (HIPAA), which strictly prohibits a health professional from sharing a patient’s information to anyone except those to whom the patient has given permission.

Cases of negligence

Zainab’s sister, 5, after receiving a chemotherapy treatment.

Zainab, a Dearborn Heights resident who wished not to disclose her last name, said her now 18-year-old sister was diagnosed with leukemia at age 5.

She said her experience with hospital staff was smooth at first.

It was not until later that her sister began experiencing additional difficulty. Zainab said the nurses and medical residents in training made some mistakes. 

She recalled a resident who used a tourniquet, which restricts blood flow to allow for easier blood draw, on her sister’s arm and left it there for a long time. 

She said her sister’s arm turned blue.

“She could’ve lost her arm,” Zainab said.

She added that the resident tried to blame a nurse but later admitted to his mistake and apologized.

Zainab said patients and their families should always ask questions and ensure they understand every step of the treatment process.

“It’s not about trusting your doctor, it’s about knowing what you’re asking,” she said.

Many people, however, unconditionally trust their doctor’s advice. 

Ali Alshahmani, 25, said his doctor is a long time family friend and would not consider switching physicians “no matter what.”

However, when asked what he would do if his doctor misdiagnosed one of his patients, he said he would immediately switch physicians, no matter how close he is to him.

“Difficult patients”

A doctor’s main duty is to nail down the correct diagnosis of an illness and propose a set of solutions or treatments. However, things can naturally go awry in doing so. It is up to the physician and the patient to work together to prevent these errors.

Dr. Craig Stevens, chair of the Department of Radiation Oncology at Beaumont Cancer Institute in Royal Oak, said the best way to avoid mishaps is for patients to have opportunities to ask all the questions they have so the best treatment can be executed.

“They’re the captain of the ship; I’m just an advisor to help them make good decisions,” Stevens said.

He added that he supports that patients seek second opinions from other doctors, as it also helps build trust when they are comfortable that the decisions are right for them.

“Ultimately, the patient will bear the burden of whatever treatments we prescribe for them or whatever operations get done to them,” Stevens added.

 Radiation oncologist Kabolizadeh echoed Stevens’ and Khansa’s coments and said the health field is moving away from “medical paternalism” toward a more shared decision-making model. 

He added that model is  the basis of trust between a physician and a patient, especially in Middle Eastern communities.

Healthcare as art and science

Many doctors are commonly confronted by patients who insist on being provided certain medicines and body scans, despite their doctor’s recommendations.

Stevens said the only time he would administer a requested test or treatment is if there was a medical justification for it. 

He added that the hallmark of modern medicine is the practice of “taking populations of people with similar characteristics, giving them different treatments, and pick the ones that works the best with the least side effects.”

Zainab, the cancer survivor’s sister, said her mother was diagnosed with breast cancer, but oncologists would not issue a full body CT scan until she demanded it.

The scan results revealed cancerous tissues in her mother’s lungs that were small enough not to be detected by prior scans.

“You have to be your own advocate,” she said.

However, Stevens explained that oncologists are required to follow national guidelines for recommended imaging for certain types of cancer.

He said scans can be dangerous if administered too liberally, because of the potential for complications with the procedures like bleeding and infections.

“That patient may have just gotten lucky,” said the radiation oncologist of Zainab’s mother.

“The best doctors are the ones that are able to blend art and science and medicine to come up with the best diagnosis and the best treatments,” Stevens said